Sheard, L., Bellass, S., McLintock, K. orcid.org/0000-0002-9479-263X et al. (2 more authors) (2023) Understanding the organisational influences on the quality of and access to primary care in English prisons: a qualitative interview study. British Journal of General Practice, 73 (735). e720-e727. ISSN 0960-1643
Abstract
Background Primary care for routine healthcare conditions is delivered to thousands of people in the English prison estate every day but the prison environment presents unique challenges to the provision of high-quality health care. Little research has focused on the organisational factors that affect quality of and access to prison health care.
Aim To understand key influences on the quality of primary care in prisons.
Design and setting This was a qualitative interview study across the North of England from 2019 to 2021.
Method Interviews were undertaken with 43 participants: 21 prison leavers and 22 prison healthcare professionals. Reflexive thematic analysis was undertaken.
Results The overarching organisational issue influencing quality and access was that of chronic understaffing coupled with a workforce in flux and dependence on locum staff. This applied across different prisons, roles, and grades of staff, and was vocally discussed by both patient and staff participants. Intricately related to understaffing (and fuelled by it) was the propensity for a reactive and sometimes crisis-led service to develop that was characterised by continual firefighting. A persistent problem exacerbated by the above issues was unreliable communication about healthcare matters within some prisons, creating frustration. Positive commentary focused on the characteristics and actions of individual healthcare professionals.
Conclusion This study highlights understaffing and its consequences as the most significant threat to the quality of and access to prison primary care. Strategies to address health care affecting prison populations urgently need to consider staffing. This issue should receive high-profile and mainstream attention to address health inequalities.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Authors http://creativecommons.org/licenses/by/4.0/. This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/). |
Keywords: | health care access; health care professionals; organisations; patient perspective; prisons; primary health care; qualitative research; quality of care |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Primary Care (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Jul 2024 16:01 |
Last Modified: | 08 Jul 2024 16:01 |
Status: | Published |
Publisher: | Royal College of General Practitioners |
Identification Number: | 10.3399/bjgp.2023.0040 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:213928 |